What "overweight" looks like and why BMI is nuts.October 3, 2007 5:37 AMSubscribe

Illustrated BMI Categories, a Flickr project where you can see what "underweight," "normal," "overweight," "obese," and "morbidly obese," BMI categories look like on real people (safe for work) (mostly women). I think that many people would be surprised by what 180lbs looks like.
In addition to not looking what you might have expected fat to look like, it may also not mean what you thought it meant:

Ampersand's analysis of a study that correlates death risk with BMI and ethnicity, including charts;

Neat project. Some of those categorizations are just unbelievable. And the "morbidly obese" link - I want to be her friend. She looks so freaking cool.posted by arcticwoman at 5:44 AM on October 3, 2007

This is a really good FPP, except for the conclusion. FPP's shouldn't have conclusions.posted by escabeche at 5:45 AM on October 3, 2007

I don't think that crazy standards mean that you should throw up your hands and do whatever. I mean, if highway speed limits were set to 5 mph, would that mean the "healthy viewpoint" would be to careen wildly around the road at 150?

And I'm not 100% convinced the standards really are crazy (although I am probably 70-80% convinced--my "normal" weight is one that I've never been, even as a starving college student). Maybe we've been getting fatter so slowly that what looks "normal" to us is a plumper than it should be. If you look at old photographs, everyone seems so scrawny...posted by DU at 5:46 AM on October 3, 2007 [1 favorite]

I don't know. If you are 5'4" 150 pounds is overweight. And these are just younger kids for the most part. Extrapolate them 20 years down the road and see what they look like. That is the real problem. Your relative risk of diabetes increases to 6.7 percent if you are just moderately "overweight." Also, it would be interesting to see their waist size since that also has strong correlation to adverse health outcomes.posted by cdcello at 5:52 AM on October 3, 2007 [2 favorites]

Wow, I was really excited to click through these links, and they are kind of cool, but the photos are so crappy (really? a wonder woman suit? a black unitard?) that it's hard for them to get their point across. It would be nice to see these pictures with everyone wearing the same thing.posted by OmieWise at 5:53 AM on October 3, 2007 [5 favorites]

Wearing the same thing would be a lot harder to arrange, however. Sufficiently harder that they probably wouldn't have bothered.

These are good looking, attractive people who take care of themselves and know a thing or two about choosing the right clothing for their body type. If you put them in different clothes and didn't style their hair, I bet we'd be calling the first one a probable meth addict and we'd have similarly unattractive adjectives for the rest.

It doesn't matter what you call it. Being very overweight puts you at a higher risk for heart disease and other things. I don't think your "people" link draws the correct conclusion. If an overweight person has made it to 80 years old, obviously they've done something right, but it's not necessarily because they're fat that they've lived longer.posted by desjardins at 6:02 AM on October 3, 2007 [2 favorites]

Wearing the same thing would be a lot harder to arrange, however. Sufficiently harder that they probably wouldn't have bothered.

Sure, but as it is many of these pictures are worthless, suggesting that the project is a poorly conceived stunt rather than a serious effort to show how different BMIs look. If the point is just to say "BMI sucks" then why not just make up the data? If the point is to show how people "really look," then fewer arty photographs and more decent ones would go a long way toward that goal.

So, yeah, I guess I should be all outraged, but the pictures are so crappy that I'm not sure where my fresh outrage begins and my background outrage starts.posted by OmieWise at 6:09 AM on October 3, 2007 [4 favorites]

And anybody else have a problem with the term "morbidly obese"? I makes me think "a fat person who spends too much time pondering death and who really is probably quite depressed and you wouldn't want to hang out with them, unless you shared their sense of humor and liked Tim Burton films, especially his early work."posted by papercake at 6:11 AM on October 3, 2007 [5 favorites]

Wearing the same thing would be a lot harder to arrange, however. Sufficiently harder that they probably wouldn't have bothered.

They're crazy. I'm overweight, but it took me a long time to accept the BMI stuff was ridiculous. If their charts are correct, I should weigh about 160 lbs to be in a "healthy" condition. I weigh just over 200 now, and I (and my doctor) know for a fact that while I'm fat, I'm not 45 pounds overweight. The only acceptable way I could drop about 20% of my body weight is if I was decomposing. If I weighed only 160 pounds, it would not be healthy; it would mean I have a tapeworm.

If you're looking for a more effective site about weight loss/dieting, I've used Calorie-Count for a while now. It's far from perfect, but instead of relying solely on calculators it lets you set your own weight loss and time period goals, and even has failsafes (for example, if you tell it you want to lose 5 pounds by next week, it tells you "Umm, no. That's crazy. Here's why.")posted by XQUZYPHYR at 6:17 AM on October 3, 2007 [6 favorites]

Another interesting BMI calculator is at halls.md. It tells you what percentage of other Americans of your age are higher and lower than you.

However, the stuff about high BMI not affecting health should be taken skeptically. Death rates aren't a particularly useful guide since there are too many confounding factors. (Are smokers thinner? Do some illnesses make you thinner? Does drug use make you thinner?)

Actual doctors and scientists tend to look at how BMI affects illness rather than just overall death rates. For instance, in women:

Even a slightly raised BMI (22.0-22.9) at follow-up was associated with an age adjusted relative risk of diabetes that was three times higher than that in women with a BMI of <>
Where exactly you draw the lines of "overweight" and "obese" is somewhat subjective, depending on what risk you think is acceptable. But you could also argue that the limits should be lower, not higher.

(we all know BMI is a crock, right? ~ becoz it's only weight in a mathematical relationship to height, failing to take into account the fact that muscle weighs more than fat. that's why brad pitt, at his most ripped, BMI'd as 'obese')posted by UbuRoivas at 6:18 AM on October 3, 2007 [9 favorites]

Am I wrong for thinking that the "overweight" people do indeed look overweight, and that the "obese" people are uniformly obese? Not one of these photos surprised me in the slightest, although obviously it's hard to guess who is normal and who is overweight between a BMI of about 23-27.posted by roofus at 6:21 AM on October 3, 2007 [6 favorites]

I, for one, did not think the latex wonder woman outfit is anything resembling "crappy"...unless that's new slang and it means "totally awesome and balls to the wall wonderful!", now.

I agree with the need to extrapolate for future health risks, but I have a problem with the standardized "normal" rating for the same reason that DU mentioned above. I actually was prioritizing speed over food the last time a doctor and a machine rated my BMI in the 100% normal range. Idiots, both of us.

There are so many factors, how is this one equation posibly going to take all of our family history, environment, activity level, and diet into account?posted by squasha at 6:21 AM on October 3, 2007

Oops, a less-than sign messed up my post. That last bit should have read:

Actual doctors and scientists tend to look at how BMI affects illness rather than just overall death rates. For instance, in women:

Even a slightly raised BMI (22.0-22.9) at follow-up was associated with an age adjusted relative risk of diabetes that was three times higher than that in women with a BMI of less than 22.0 at follow-up.

Where exactly you draw the lines of "overweight" and "obese" is somewhat subjective, depending on what risk you think is acceptable. But you could also argue that the limits should be lower, not higherposted by TheophileEscargot at 6:22 AM on October 3, 2007

suggesting that the project is a poorly conceived stunt rather than a serious effort

It's on flickr. Lets say that again: flickr.

The site can't even spell their own name correctly, and you were expecting a Lancet article?posted by aramaic at 6:24 AM on October 3, 2007 [3 favorites]

I don't even understand this one. She's fit, and she's classed as "normal". The only "better" category than "normal" is "underweight", which is anorexia bad. It's not something to strive for.posted by smackfu at 6:25 AM on October 3, 2007

Anyone else see the social commentary on such a huge majority of females, to discuss weighty matters?

And "Steven", who is "1 lb shy of normal": What kind of 'study' says 1 pound shy, without explaining over or under? The photo makes it clear though, he's skinny.

And then there's 'Brian', who is 'overweight'. I'm sure that would be fair enough, if he were 16. But for a man his apparent age, I wouldn't say overweight. To me, he looks trim.posted by Goofyy at 6:37 AM on October 3, 2007

No wonder you hear so much about beautiful girls with anorexia. I can't imagine looking like that and still being told that I was overweight.posted by JDHarper at 6:38 AM on October 3, 2007 [4 favorites]

I would be significantly more likely to care about BMI is the obese and morbidly obese catagories were respectively renamed "bobatty" and "boombalatty."posted by allen.spaulding at 6:43 AM on October 3, 2007 [2 favorites]

I swear that people see "overweight" and read it as "morbidly obese", or something. You can be overweight without being "lol fatty".posted by smackfu at 6:43 AM on October 3, 2007 [1 favorite]

I agree that the lady JDHarper links to does not look overweight but when I consider that she weighs 6lbs less than me (and I'm far from skinny) and is 6 inches shorter than me then it sounds more plausible.posted by jontyjago at 6:46 AM on October 3, 2007

OMG muscle is denser than fat so BMI is a crock !!!!1
Yes, we get it. Everyone knows (should know) that. It's a starting point, an additional measurement, an easily calculable statistic, it's not the be-all-end-all of physical analysis. Besides, if you're worried because your slabs of rock-crushing pecs are throwing off your BMI, I don't think you've got to concern yourself about it too much.

(Though I do acknowledge that BMI measurements may be abused by insurance companies etc., so education and access to other risk-measurement options is key)

BTW, if you're back in the states and you want to screw up your notions about BMI, come out for a vacation here in Japan (^-^)posted by damo at 6:51 AM on October 3, 2007 [5 favorites]

Neat idea. Could have been done better, but it really does help point up the shortcomings of charts and the BMI as a ideal weight determinant — your ideal weight should be a consensus between you and your doctor. I'd like to show this to the many people out there who think any woman who weighs over 140 must be fat.

I find men especially tend to have a very unrealistic concept of what women weigh and what they should weigh. They always guess me to weigh 20 pounds less than I do, no matter what kind of shape I'm in. I don't think it's entirely their fault. They simply don't know what women weigh because the women they've known either don't tell them or lie about it. So if a reasonably trim woman who weighs 140 tells a man she weighs 125, he gets the idea that a woman who weighs 140 pounds must be chubby. Meanwhile, I know what my dad and my three brothers and my nephew weigh, and a lot of my male friends and dates have told me what they weigh, so I can make a pretty shrewd guess as to what a man weighs, and I know that it's entirely possible for three 6' tall men to weigh 175, 200, and 225 respectively without any of them needing to either lose or gain any weight.posted by orange swan at 6:52 AM on October 3, 2007 [1 favorite]

And "Steven", who is "1 lb shy of normal": What kind of 'study' says 1 pound shy, without explaining over or under?

uhm. that was my wording. i was one pound below "normal" when that photo was taken.

my impression was not that the project was conceived of as a formal "study," (i mean... are you serious?) but just as an informal way to put a human face (and body) onto the arbitrary category distinctions that medical professionals foist upon us.

A lot of those photos are shot in classic LiveJournal/match.com "fat girl angle shot" style. The right angle can make anyone look thinner than they actually are.posted by elmwood at 6:58 AM on October 3, 2007 [3 favorites]

I like how the skinny girl is hiding behind a banjo.posted by smackfu at 7:02 AM on October 3, 2007

TheophileEscargot: That's really cool. I'm on a sort of weight loss kick right now, and it's neat to see success stories like that.posted by JDHarper at 7:03 AM on October 3, 2007

I really enjoyed all of these images. They made me feel quite good about my own body and reminded me to keep trucking on at going to the gym and being healthy instead of stressing out that I'm not a size 6. Thank you for the links, Salamandrous.

And then I read the blue to be reminded that OMG since I'm "Morbidly Obese", I'm going to die die die. Or at least I should remember that I'm at a high risk of getting diabetes and dying. So at least all is still normal in the blue...posted by idigress at 7:06 AM on October 3, 2007

I think people's problem here is dealing with the sudden disconnect of "Person of healthy weight" and "Person I find attractive." We're used to associating "Obese" and "Overweight" with LOLFATTIES, so when we realize that oh man, that hot chick is overweight we automatically assume something must be wrong with whomever or whatever is calling her overweight. Someone may be attractive, but that does not mean they're at a healthy weight--whether they're too skinny or too fat.

This doesn't mean BMI is bullshit or all the studies linking a high BMI or high weight to health problems are wrong. It means we have to redefine what "attractive" means. We automatically assume we find healthy people attractive. But let's face it, from a strictly medical viewpoint what society has found attractive has not always been healthy. Take heroin chic. Take people transformed by plastic surgery. These are things that may not be immediately repulsive to some people, but what effects do they have 30, 40 years down the road on the person's health?

So, I think it is great for people to realize that yeah, your BMI or body fat percentage doesn't have to be perfect for you to be sexy. But that doesn't change the fact it those measurements might have something to do with whether you're healthy. It is a choice you gotta make.posted by schroedinger at 7:12 AM on October 3, 2007 [13 favorites]

Examples of "overweight" such as this, certainly make me think the whole system needs some serious refinement...such as taking into consideration fat/muscle ratios.posted by Thorzdad at 7:16 AM on October 3, 2007 [1 favorite]

I think more needs to be done about the "analysis" that you linked to... the main thing would be controlling for income here?

black women could have completely different circumstances for weight than other cultures, that would cause mortality to be higher for "normal weight" individuals...posted by stratastar at 7:22 AM on October 3, 2007

There's only one way to do this. Get a bunch of humans who are the same height, and take nude shots of them all standing next to one another in a line-up (blurred faces, if necessary).

Start on the left or right (whichever) and go up the BMI.

For instance, get a bunch of guys who are 6'2". Start with a guy who weighs 140, then a guy who weighs 170, then a guy who weighs 200, then a guy who weighs 230, etc.

Examples of "overweight" such as this, certainly make me think the whole system needs some serious refinement.

She's right on the border though. She has a BMI of 25, and normal is up to 24.9. In the morning she might be "normal".posted by smackfu at 7:36 AM on October 3, 2007

I'm always telling the people with "weight" problems in my life.... throw out your scale. Now look in the mirror and see if you're happy with your appearance. Now bend over from the waist and touch your toes. If you feel a squeezing on your lungs when you reach for your toes, you are fat and you need to think about getting more exercise.posted by autodidact at 7:45 AM on October 3, 2007 [1 favorite]

You know, it is interesting that these photos are ostensibly promoting a "all body types can be beautiful" viewpoint--because rather than acknowledging that "overweight" and "obese" can be attractive, people want to scrap the whole system and label those body types as "normal". There's such a deep-seated negative connotation with being called "overweight" or "obese" that even when we're trying to promote those body types we refuse to use those words. I mean, if you are trying to promote acceptance, call them what they are. You're obese and you're pretty. There you go. That's it.

Maybe people are afraid of the implicit medical judgment of those classifications because being over a healthy weight carries health risks. But you know, so does smoking and eating junk food, and yet smokers don't try to redefine "smoker" as "non-smoker" and pizza-lovers don't refer to pizza as broccoli. People participate in these unhealthy behaviors but still call a spade a spade. If you're going to be fat, and are happy being fat, then dammit, go and be fat! But don't try to classify yourself as "of healthy weight", because it's not, no more than eating excess junk food or smoking is healthy.posted by schroedinger at 7:50 AM on October 3, 2007 [14 favorites]

I'm sorry but if you're 5'3" and 185 lbs, you are fat. And, amazingly, BMI is totally 100% correct in this case.

Being fat doesn't mean you have to be bad looking though. Anyone can pretty up fat if they take the time to figure out how but that doesn't change the fact that you're fat.posted by Stynxno at 7:53 AM on October 3, 2007 [1 favorite]

also, a hell of a lot of those pictures in the set fall in the "MYSPACE FAT GIRL" picture angles.

This flickr page is about apperances when BMI is really used to argue health. If you've ever seen an episode of What Not To Wear you will know that people of all shapes and sizes can dress well and look good. That's all this flickr collection is showing. It's not an effective arguement against BMI or anything else.

In fact, if it wasn't labeled with BMI, I wouldn't be surprised if this was just a flickr page devouted to a creepy chubby chaser.posted by Stynxno at 8:00 AM on October 3, 2007 [1 favorite]

Morbidity as a medical term tends to be used to imply the presence of noxious and / or debilitating medical problems/complications as opposed to death (mortality). There's simply no way to talk around the issue that being overweight is going to bring a person into the office at a much more frequent rate for complaints of pain, fatigue, menstrual irregularity and other endocrine problems, skin problems, arthritis, shortness of breath, falls, etc. I see a lot of pictures of young vigorous persons that in the next ten years are going to be less vigorous and starting to experience all the myriad issues of the obese, and who will be less capable than ever to change the path they are on.

So it's hyperbolic to claim that obesity=death. It doesn't. It's just a platform for a lot of problems that can't be solved without weight loss. And since weight loss, statistically, is less successful than smoking cessation or stopping egregious dietary habits, we are staring into a health-care abyss.posted by docpops at 8:02 AM on October 3, 2007 [3 favorites]

At my skinniest (also my most broke and unemployed), people could see my ribs through my clothes, and I had sunken cheeks. Close friends and family said I was looking skinny, and not in a good way. My BMI said I was "normal". The idea of the BMI is fine, but the lines of seperation are placed in stupid places.posted by 23skidoo at 8:15 AM on October 3, 2007

I like this photoset. Sure, some of the photos are carefully posed, and they're all dressed nicely, but if I were going to submit a picture of myself to a photoset that might be viewed thousands of times I'd want it to be a good photo of me too.

I just see it as a reminder that the same BMI can cover a range of shapes and sizes, and that what is classified by BMI as "overweight" or "obese" is often a long way from what the general perception of someone who is overweight or obese is.posted by penguinliz at 8:19 AM on October 3, 2007

I love this project. I think the photos are fantastic.

Those of us who are in the know about "HAES" can chuckle at the commenters who have no actual bearing on other people's lives.posted by TheClonusHorror at 8:23 AM on October 3, 2007

I'm still fat but I can kick your butt in spin class.posted by konolia at 8:44 AM on October 3, 2007

I recently stopped biking for three months. My quads shriveled down to toothpicks and I lost 20 pounds. My doctor congratulated me on reaching my "target weight", and said we should get even more aggressive -- my BMI was finally in the "normal" range but still close to "overweight".

Meanwhile my body fat percentage as measured on my home scale hadn't budged, my water percentage dropped by a couple of points (muscle is water bearing) and my love handles are still a handful. I've started riding my bike again and lo and behold my weight is creeping up once more.

Having an extreme BMI is a wake-up call, but BMI is a terrible way to track the progress of a fitness program. Body fat percentage is a good start, but determining your "ideal" percentage is a matter of gender and genetics.

That said, I get the impression that most people who complain about BMI are using its failings as an excuse to avoid doing anything about being overweight.posted by xthlc at 8:46 AM on October 3, 2007 [1 favorite]

Using the word "chubby" to describe those who fall in between "overweight" and "obese" would clarify things immensely.posted by wfc123 at 8:48 AM on October 3, 2007

TheClonusHorror: HAES is a nice idea--I think promoting a healthy relationship with food, exercise and one's body is fantastic and absolutely necessary for dealing with the psychological trauma that can come from being overweight in a society that hates fat people.

But because you can be obese and healthier than most obese people does not mean you are not still at a higher risk for weight-related afflictions than you would be if you had those healthy habits and were at a lower weight. That's the fundamental issue here. My great-aunt has lived her life overweight to obese. She was physically and socially active, ate well, and quite happy. Unfortunately, that has not changed the fact that in her 60s she is now suffering from severe diabetes, can barely move around outside her house, and will probably need to have her foot amputated. Would this be the case if she was not grossly overweight? I really, really doubt it. And you have no idea how fucking tragic it is to watch this vivacious, social woman become housebound and essentially give up on life because the severity of these issues have caused her to lose hope.

Would you be better off going through gastric bypass and taking lots of meth to get down to that weight? Of course not--I think gastric bypass is one of the most medically irresponsible procedures ever conceived in recent history. But should your goal still remain gradual, steady weight loss? Yeah, yeah it should. HAES is good, except when it acts as a substitute for resolving the long-term issue.posted by schroedinger at 8:50 AM on October 3, 2007 [1 favorite]

Using the word "chubby" to describe those who fall in between "overweight" and "obese" would clarify things immensely.

Or voluptuous.

And Sarah is the fattest triathlete I've ever seen.posted by smackfu at 8:57 AM on October 3, 2007

Finally. Something to show how BMI completely does not work. BMI does not take into consideration bone density mass.

It's just madness. The BMI index is probably created by some nutritionist who's sleeping with a modelposted by schiddin at 8:59 AM on October 3, 2007

I'm wondering if the intent of the absurdly low "normal" category is to fuel the multi-billion dollar diet industry (i.e. tax revenue and health spending). The health industry/regulatory agency is no stranger to corruption.posted by rolypolyman at 9:08 AM on October 3, 2007 [2 favorites]

The Tom Cruise thing seems to come from "estimates" of his height and weight based on looking at his photos, not from any actual source. One such estimate puts him at 5'7' and 201 pounds, which would indeed give him a BMI of 31.5, just in the obese range.

Now at 201 pounds, if he was a boxer, the diminutive thespian would be in the super heavyweight class. Now yes, he works out a lot. But do you really see him going into a boxing ring against Mike Tyson? I don't think those figures are realistic.posted by TheophileEscargot at 9:17 AM on October 3, 2007 [1 favorite]

Looking over these again it's hard not to feel some skepticism over the obvious way the flickr poster is trying to undermine the BMI. Every person in these shots, with the exception of the triathlete, is clearly able to offset the effects of their weight by the simple fact that they are young and active. The second anything develops in their lives that limits their freedom to dictate their activity levels (read: kids/job issues, etc.) their weight will not only escalate but so will the health problems.

An earlier poster commented on rugby players being overweight. Perhaps at this point in their lives they don't see what awaits them, but my waiting room is full of ex-athletes who are fat as whales and looking at their first MI as soon as they stop centering their lives around athletics.

And as far as gstric bypass surgery being irresponsible, walk in the shoes of a 400 pound human being for a month or one day and then see what you think.posted by docpops at 9:17 AM on October 3, 2007 [2 favorites]

I'm wondering if the intent of the absurdly low "normal" category is to fuel the multi-billion dollar diet industry

BMI is the result of statistical modeling. Normal is not "absurdly low". In fact, it likely represents the sweet spot on the bell curve of "healthy" results witnessed. Stop using the BMI to determine whether or not you are fat. Only use it to determine if you are more or less likely to have health problems related to your weight.

If you want to know if you're fat then measure your body fat percentage and compare it to these norms as determined by the American Council on Exercise.posted by sequential at 9:21 AM on October 3, 2007 [1 favorite]

Right I've used body fat percentage during training regiments. I don't use it as an absolute, but it helps me keep an optimum weight. When I work out heavy, my fat generally increases (and thus the body fat percent increases), before I begin taking on the muscle weight. Indeed, if I get busy and miss a weeks worth of workout the weight is put on in fat (I am intaking more food as my body thinks I will be working out heavy). My lowest body fat percentages actually occur during my sedentary periods where I am doing nothing, and prone to eat a lot less meats and carbs.

In any case, that is not normal for a population (which is what BMI measures). Obviously if someone is active and athletic, the BMI means little.

I hardly believe that bone density or muscle on a normal, non-active person really is enough to push one way outside what would be their "correct" BMI range.posted by geoff. at 9:26 AM on October 3, 2007 [1 favorite]

/slight derail
Interesting comments on the language used :- "morbid obesity" is not as bad as the term "habitual aborter" which used to be used 20 years ago for women who suffered multiple miscarriages. Imagine reading that in your notes!posted by Wilder at 9:28 AM on October 3, 2007

Oh my, what a joke.

I've never paid much attention to this BMI thing, and was a bit skeptical that it could be done over the internet. But I clicked the link anyway - and found a calculator which only needs my height and my weight? Seriously?

How does it know how much of the weight is muscle vs fat? How does it know my bone density? My activity level? It doesn't.

This is just more bullshit for anyone addicted to the idea that people are interchangeable standardized units. If we discouraged a focus on indices and formulae, and encouraged, from childhood, a culture of listening - really listening - to our own bodies, so that we eat what we truly need and want, and got the kind of activity we needed, everyone would be a whole hell of a lot better off, there'd be no one making a career out of this roadshow medicine, and hot people wouldn't simply get called "overweight" as if it were a useful pronouncement.posted by poweredbybeard at 9:38 AM on October 3, 2007

/furthering the derail
Shouldn't it go further? Why isn't there a "morbidly underweight"?posted by sephira at 9:40 AM on October 3, 2007 [1 favorite]

More pictures of people over 25 would be neat. Our bodies change as we age.posted by desuetude at 9:47 AM on October 3, 2007

What an interesting project. What I've always thought as "normal" seems to be "obese" in BMI land, confirming my preferences haven't changed a bit :)posted by tommasz at 9:51 AM on October 3, 2007

BMI is broken because it ignores the weight of muscles and bones and other important bits of the body.

These photos show that it is indeed possible to be fat and sexy--something most of us have already figured out. It is, however, difficult to be fat and healthy.

BMI is simply one small rule of thumb in a world without fingers: you aren't a number and you're probably sexy, but if you come up as obese or morbidly obese, it's time to get your cholesterol checked.

I second everyone who has suggested the nude lineup. Now that would be very, ahem, revealing, and tell us quite a bit more than these mostly glamor shots.posted by dead_ at 9:52 AM on October 3, 2007 [1 favorite]

This is why body fat percentages are much more useful than BMI.posted by Talanvor at 9:53 AM on October 3, 2007

Tom Cruise is 160-165 lbs, maybe lighter for some films.posted by autodidact at 9:54 AM on October 3, 2007

All I cared about was finding one or two of these women that are my height and weight so that I can obsessively compare myself to them. No luck.posted by amro at 9:55 AM on October 3, 2007 [6 favorites]

If you want to know if you're fat then measure your body fat percentage and compare it to these norms as determined by the American Council on Exercise.

Failing that, men, take your chest to waist ratio, and get it below .8.posted by Kwantsar at 9:58 AM on October 3, 2007

There is no WAY Tom Cruise is 200 pounds. I bet he is barely 160lbs.

I've seen Cruise in person. He is a punk. The dude looks anorexic. I know a combat coach who worked with him and the set him up with their smallest guys.

My Jiu Jitsu coach is about 5'-7" with the same frame and in athletic condition— also former varsity wrestler like Cruise— he weighs maybe 145lbs or 150lbs soaking wet.posted by tkchrist at 9:59 AM on October 3, 2007

I am classified as overweight by BMI standards — 6ft and 194lbs is way overweight.

No, it isn't "way overweight". It's a quarter of the way into the range.posted by Kwantsar at 10:03 AM on October 3, 2007 [1 favorite]

Its funny, when I learned that my "ideal weight" is roughly 140-160 lbs (for a 24 year old male, 5'9), I almost shat my pants. The last time I weighted 160 lbs was in sixth grade.

So, yeah, I'm a porker. And yeah, I'll have health problems down the road because of it. (Shit, we're all going to have health problems down the road...) But I'm not loosing 100 lbs so I can look like a "healthy" cancer patient. I (and my doctor) will be happy if I can get below 210. Thats what really matters: how you feel about yourself and your doctor's trusted opinion.

Also, virtually all the women in those photographs are way more attractive (physically and personally) than any model in just about any magazine.posted by Avenger at 10:07 AM on October 3, 2007

Failing that, men, take your chest to waist ratio, and get it below .8.

Sounds easier to measure than body fat percentage. How do I calculate that ... divide my chest measurement (at the nipples) by my waist (below the navel)?posted by and hosted from Uranus at 10:07 AM on October 3, 2007

How do I calculate that ... divide my chest measurement (at the nipples) by my waist (below the navel)?

Chest at the nipples, waist at the navel. If you're fat, the navel will give you the biggest reading. If you're thin, it will give you the smallest. By design, of course.posted by Kwantsar at 10:16 AM on October 3, 2007

Avenger, your doctor is giving you a realistic target to encourage you to try losing weight, not declaring 210 healthy. Doctors also tell two pack a day smokers to dial it back to one pack a day.
I guarantee that should you show up in the doctor's office weighing 190 he would not recommend gaining 20 lbs.posted by leftoverboy at 10:19 AM on October 3, 2007 [1 favorite]

I guarantee that should you show up in the doctor's office weighing 190 he would not recommend gaining 20 lbs.

Oh I know. I would never argue that even being 5'9 and 210 is "healthy" in the sense that I'll never have problems because of it. For me, its a trade-off. I want to loose weight (and I am, hooray!) but I'm not going to put myself through the wringer to look like a 12 year old boy again -- even if it means a stint in my arteries when I'm 50.posted by Avenger at 10:24 AM on October 3, 2007

I did a stint in my arteries once. Man, I've paid my dues. I'll never go back to that hellhole.posted by amro at 10:36 AM on October 3, 2007 [1 favorite]

I think people's problem here is dealing with the sudden disconnect of "Person of healthy weight" and "Person I find attractive."

Exactly. Except then the problem continues when people try to make themselves feel better by redefining what "healthy" is -- that thin person? She needs a sandwich. That guy? Looks like a cancer patient. Healthy looks... why, like me!

It looks to me like any woman with a breast size above a B cup is classified as "overweight." No wonder so many women have body image issues.posted by jonp72 at 10:40 AM on October 3, 2007

Discount BMI and you discount an overwhelming amount of scientific research linking it to an increased risk for heart disease, diabetes, pregnancy complications, cancer, etc.

It's obviously not the only important vital statistic. But it is telling. And in combination with blood pressure, cholesterol measurements, body fat percentage, etc. you can get a bigger picture.

Sure, if you're a body builder or professional athlete, BMI isn't going to be a useful measurement. But 90+% of the population can usefully be categorized with BMI. You don't have to worry about bone density or muscle mass because the classifications are relative - meaning those things affect everybody in each category similarly.

BMI isn't about a model obsessed culture or insurance companies. It's about predicted health outcomes based on volumes of studies.

I'm surprised by the general sense of dismissal in the comments. Maybe the BMI categories need to use less vernacular terms so that someone in the "overweight" category, who looks at himself in the mirror and doesn't think of himself as "fat", isn't turned off by the classifications.posted by Grundlebug at 10:42 AM on October 3, 2007 [3 favorites]

I'm Reubenesque.

Well, I've got sauerkraut and Thousand Island stains on my shirt.

Cool project - yeah, the poses and attire have a huge impact on the photos, but the message behind it is one of confidence, happiness, and as much as I hate the word, empowerment, three factors that are just as important for living a healthy life as exercise and proper eating habits, IMO.posted by Alvy Ampersand at 10:44 AM on October 3, 2007

And yeah, cute playing with the category boundaries without making it apparent just how far into the category you are. "Overweight" pic -- BMI 25, or 25 and change. "Underweight pic" -- BMI 16 and change? Why not 17.9? Ohhh, just explore the boundaries in one direction. I see.posted by dreamsign at 10:45 AM on October 3, 2007

BMI was not invented by a nutritionist dating a model (schiddin), nor is it the result of statistical modeling for insurance companies (InnocentBystander). The BMI was invented by Adolphe Quételet, a 19th-century Belgian for a totally different purpose than it is used for today. The insurance companies love it because it lets them fuck over people entirely randomly, and the diet industry loves it because ditto ditto.

DU says "If you look at old photographs, everyone seems so scrawny..." There are plenty of photographs of heavy people from earlier centuries, and there are a million reasons people in old photos could be skinny - people got bigger as proper nutrition became more readily available (go on any tour of a home preserved from the 18th century and look at the length of the beds and the size of the chairs. People were smaller all over), so plenty of folks were skinny from lack of proper diet, disease, etc. Plenty of folks were fat, too -- oftentimes the rich, as it was a sign of wealth (you could afford lots of food). Plus there's just plain ol' genetics. Some people are fat. Some aren't.

BMI is broken because it ignores the weight of muscles and bones and other important bits of the body.

BMI is based on the average amount of bone density and muscle mass in men and women. Yes, it fails when you're athletic, especially if you're very muscular and lift weights. But to all you people screaming it's useless--are you arguing that the vast majority of Americans are lifting weights and getting so ripped it skews your BMI measurement? Let's be realistic here. It doesn't apply to the very athletic, but how many of us count among the very athletic?

I echo those who point out the categories are not hard-and-fast, and people pretending they are are being obtuse. I was once down to 125, ostensibly a health weight for 5'6'. I looked like I had an eating disorder (which I did). So my frame is big-boned. But I don't for a minute think this means when my body fat percentage climbs to 30% and my weight climbs to 200 that I'm "healthy" and "this is how I was built!"

And as far as gstric bypass surgery being irresponsible, walk in the shoes of a 400 pound human being for a month or one day and then see what you think.

Docpops, I understand where you're coming from. But the long-term effects of gastric bypass are only beginning to be understood now. Patients have to maintain an extremely strict diet to ensure they don't become malnutrition--and considering that many of these patients ended up where they are because of their inability to maintain a strict diet this seems like a joke. And I've read that a number of gastric bypass patients gain the weight back anyway, despite their reduced stomach size. One could argue that these reasons, on top of all the other myriad side-effects that come with it (including all the relatively high mortality rate of the surgery) make it far from the ideal choice. Gastric bands seem like a less drastic idea--you maintain many of the complications, but at least it's somewhat reversible.

I'm not a doctor. This is just from the improptu PubMed/pop-sci research I've done, so it is quite possible you know more about this than I do.

The worst part about weight loss is having to buy a new damn wardrobe.

My new "No, I'm not on a diet, but building some good habits I can sustain" program has taken me down over 20 pounds (5'11.5", 275, but people regularly underguess my weight).

Not worrying about BMI, but I had a terrifying moment with a friend's blood sugar tester that started it.posted by Samizdata at 11:03 AM on October 3, 2007

schroedinger - I agree with all you said. We're in a complete mess. I don't know what the answer is.posted by docpops at 11:14 AM on October 3, 2007 [1 favorite]

Why do so many people feel compelled to point out the exact same thing about BMI not taking into account that very fit or muscled people can fall into the overweight category when they shouldn't? Do you people think this is news to anyone, including the people who use BMI regularly?

From the CDC web page on BMI:

It is important to remember, however, that BMI is not a direct measure of body fatness and that BMI is calculated from an individual’s weight which includes both muscle and fat. As a result, some individuals may have a high BMI but not have a high percentage of body fat. For example, highly trained athletes may have a high BMI because of increased muscularity rather than increased body fatness. Although some people with a BMI in the overweight range (from 25.0 to 29.9) may not have excess body fatness, most people with a BMI in the obese range (equal to or greater than 30) will have increased levels of body fatness.

It is also important to remember that weight is only one factor related to risk for disease. If you have questions or concerns about the appropriateness of your weight, you should discuss them with your healthcare provider.

What is with all the people bringing up this strawman? Agenda much? BMI isn't supposed to be the end all and be all. It is a general, quick and dirty way for people to eyeball their fitness level.

If you are so athletic as to distort your BMI I guarantee you aren't using BMI. Do you think a champion triathlete is looking at their BMI and going "OH MY GOD I NEED TO LOSE WEIGHT!"? Of course not.

Unless you are one of these apparently ubiquitous health nut athletes bringing this up constantly is just a strawman so people can feel better about the fact that they are fat.posted by Justinian at 11:21 AM on October 3, 2007 [5 favorites]

You know what? Posts like this make the ED girl in me shudder. "Am I attractive? How much data can I compile to make me feel guilty/acceptable?" It's too bad panic attacks don't count as cardio.

I've learned that at 35, I'm attractive FOR MY AGE. Not only that, but people typically guess me to be early to mid-20's. When I was that age, other girls looked like sleek, pornographic animals to me: no stretch marks, cute outfits, confidence.

I went to the doctor and point-blank asked what my weight should be, told her how much I worked out, and had her do bloodwork.

At the end of it all she said, "If you exercise 60 minutes a day, 7 days a week, your cholesterol is normal, your thyroid is normal, you aren't abusing drugs and alcohol, you sleep at least 6 to 7 hours a night, have a couple of favorite outfits that you feel sexy in, and have a significant other that finds you attractive, which means you have a healthy sex life, then numbers are irrelevant. THAT is your ideal weight. Your health is more important than the media's standards of what is attractive. Worrying about it causes undue stress; yoyo dieting, over-exercising, or taking experimental supplements do more harm than good."

It has stuck with me, and I'm passing it on now to any of the women out there who are suddenly wishing they had a tape measure at their desks or feel like bashing in some of the commenters' heads with their scales.

Perspective is often the only way to find your personal truth, you know?

Grundlebug and schroedinger's points are pretty much what I'd say -- BMI is not a statistic that is inherently valuable on its own without other measurements, but it is a number that would cause a doctor or fitness expert to look at those other statistics. It's not going to be a useful number by itself if you have a different bone mass, more muscle than the average person, or a number of other factors that could push you away from the mean average.

But look at it this way: it might be obvious if you go into the doctor and look athletic that you'll have a skewed BMI, but there are other factors that could cause that number and your appearance to have an apparent mismatch that might be indicators of problems.

The use of the terms "overweight," "obese," and "normal" are historical and arbitrary when used in conjunction with this scale. If you're offended by being called obese, then pretend it's a 1 through 5 scale and you're toward the 4/5 end. The scale has absolutely nothing to do with attractiveness, so comments like "oh, there's no way she's obese because she's hot!" come off as dumb. It's an incredibly arbitrary scale. That would be like saying, "There's no way it's freezing outside, because it's so sunny!"posted by mikeh at 11:36 AM on October 3, 2007 [1 favorite]

walk in the shoes of a 400 pound human being for a month or one day and then see what you think.
posted by docpops

I do, every day and every month. Do you speak for me now? I don't remember voting?!posted by Megafly at 11:38 AM on October 3, 2007

Also, the alternative to loosing a few pounds in order to slip into the "normal" range might be to grow a few inches.posted by sour cream at 11:39 AM on October 3, 2007 [1 favorite]

This confirms what I suspected for a long time: Most obese people are women.

I'm willing to bet Sarah's not setting any records in her triathlon career.

Me thinks people throw around the term triathlete a bit too loosely. A sprint triathlon can be super short: 1/4 mile swim, 6 mile bike, and 1.5 mile run (and some come in even shorter than that). Then throw in the fact that most sprints have a ridiculous time limit to account for the morbidly obese and elderly. Just b/c you can float your way through the swim, take a casual bike ride, and walk the run section, doesn't mean you should call yourself a triathlete.posted by ShadowCrash at 11:41 AM on October 3, 2007 [1 favorite]

I went from barely Obese down to Normal, going from 240 to 170 lb. (6'-2" male). At 170, concerned friends asked if I was ill. I looked too thin. At that weight, though, I was able to shed all my daily pills- cholesterol, blood pressure, acid reflux, etc.- and felt very healthy.

In the two years since, I've gained half the weight back. At about 205, people still compliment me on my weight, but... to be honest, I'm back on acid reflux and blood pressure meds. If I can manage to lose back to the "Normal" weight of 194, I bet the blood pressure would go down. If I was eating consistent with a weight loss plan, the acid reflux might no longer be necessary.

So, in my personal case, I think the BMI is dead-on accurate.posted by Doohickie at 11:41 AM on October 3, 2007

Anyone can pretty up fat if they take the time to figure out how but that doesn't change the fact that you're fat.

stynxno: I wouls be more inclined to listen carefully to you about cutting the crap and calling fat fat if it didn't always sound so damned derogatory when you talk about it,posted by Ambrosia Voyeur at 11:46 AM on October 3, 2007 [2 favorites]

schroedinger: Yes, really. "The prevalence of obesity is higher for women (34 percent) than men (27.7 percent) as is severe obesity; women (6.3 percent) and men (3.1 percent)."posted by desjardins at 11:58 AM on October 3, 2007

I do, every day and every month. Do you speak for me now? I don't remember voting?!

Oh for christ's sake! There was nothing derogatory or condemnatory in his comment. And it wasn't addressed to you. Lighten up.posted by OmieWise at 12:03 PM on October 3, 2007 [1 favorite]

desjardins, those work out to approximately a 45%-55% men-women split in the obese population. That's hardly a vast majority.posted by schroedinger at 12:06 PM on October 3, 2007

Huh, so me and Brian Urlacher are obese.

Man, I should really stop lifting weights it’s really making me fat.posted by Smedleyman at 12:19 PM on October 3, 2007

Me thinks people throw around the term triathlete a bit too loosely.

Yeah, I've noticed that as well. People think ironman, but I don't think it's a huge step going from a 5k to a small triathlon. You just need to be able to swim, since the bike part is not going to knock anyone out. And I've seen plenty of 5k "runners" who were not fit at all. I think the whole metric thing throws people off.posted by smackfu at 12:26 PM on October 3, 2007

Thanks for contributing to the strawman, Smedleyman. We can never have enough straw.posted by Justinian at 12:30 PM on October 3, 2007

schroedinger: No one said "a vast majority." sour cream said "most." Most obese people are women. Women are severely obese at twice the rate of men.posted by desjardins at 12:36 PM on October 3, 2007

Yeah, I think sour cream was joking. Still, it's interesting that 2/3 of morbidly obese people are women. I don't know why that should be unless morbidity among really really fat men is higher than among women?posted by Justinian at 12:48 PM on October 3, 2007

As a triathlete, I'm getting a kick out of... oops, sorry, "metafilter" not "fark".

The morbidly obese "triathlete" example adds nothing to this discussion. Declaring oneself a triathlete is similar to declaring oneself a "banjo player": It doesn't mean you're good at it, or fast. At most it implies you own a banjo. (Yes, I'm a triathlete who owns a banjo.)

I used to get involved in these discussions to help explain BMI and how it's a good first approximation in a population, but can fail individually. Then I started getting miffed at stupid fat people making claims about triathletes, wrestlers, and Tom Cruise being "obese" by BMI standards, therefore their own obesity didn't count. Foo.

Justinian - the CDC may say one thing based on a variety of factors so may a physician.

But a HMO or Insurance provider is looking at a god damned BMI chart. Period. It's big problem.

That is who uses BMI the most. And that is why it's bullshit.

It's like IQ's. IQ is not that useful of metric unless other factors are taken into account... then in can be predictive of many, many, things. But look who abuses the IQ metric?posted by tkchrist at 1:04 PM on October 3, 2007

At 6'2" 210, I'm considered overweight. I could laugh it off, except my high BMI was listed as a factor for why I was denied health insurance.posted by Mach3avelli at 1:20 PM on October 3, 2007 [1 favorite]

MY GOD! Mach3avelli is a dog! A dog that can can type!!!posted by tkchrist at 1:25 PM on October 3, 2007

Mach3avelli, if you lost the dog, that would drop at least 20 lbs off your weight and put your BMI in the normal range. I'm just saying.

Really? They denied you coverage for a BMI of 27? That's just ignorant.posted by sequential at 1:32 PM on October 3, 2007

Does anyone know if anyone has ever been denied health insurance for being on the underweight end of the BMI scale? I'm appalled that anyone gets denied for just their BMI score (which is an indicator but not the be-all of determining healthy weight), but I may finally be getting health insurance for the first time, and now I am worried. I fall well within the "so underweight I blow away in a breeze) end of the scale.posted by Orb at 1:44 PM on October 3, 2007

Well, that's a problem with health insurers not with BMI. If they didn't use BMI they'd use something equally inane because their goal is not to help you get insurance it is to make as much money as possible. Denying health insurance to people with high BMIs is good from a strictly actuarial standpoint because they are statistically more likely to get sick.

Now, a health insurer could spend a bunch of money to investigate whether your high BMI is because you are fat or because you are muscular, but it is not cost effective. Most people have high BMIs because they are fat and it isn't worth the money to an insurer to dig for the people who aren't fat.

This is one reason why health coverage in the United States is broken. It is not, however, a problem with BMI.posted by Justinian at 1:47 PM on October 3, 2007 [1 favorite]

On the internet, no one knows you are a dog.posted by caddis at 1:49 PM on October 3, 2007

I'm shocked that no one has posted a link to last week's metafilter post on Gary Taube's article in New York magazine. I went out and bought the book "Good Calories, Bad Calories" that the article is adapted from. The book is a must read if you're going to consider yourself knowledgeable about the current state of science on diet, weight, and health. Although tangentially related to this BMI discussion, the book lays out the history of how the prevailing wisdom and "common knowledge" regarding weight, diet, and health has been lead astray and is no longer grounded in scientific reality.posted by herda05 at 1:57 PM on October 3, 2007

If the article is any indication of the quality of the book, then the only statement the book makes about the current state of the sciences of diet, weight, and health is that everyone has their own opinion which they think is right.

I know, don't judge a book by an article adapted from the book, right?posted by sequential at 2:06 PM on October 3, 2007

Some of this discussion (and I think what the FPP is alluding to) is downright silly. BMI has nothing to do with attractiveness or body image, it has to do with health and medical standards (and these are also in debate).

If you say "overweight person looks great to me, therefore BMI is meaningless" you're missing the point entirely.posted by meowzilla at 2:21 PM on October 3, 2007 [1 favorite]

The only thing this proves is that good clothes and a nice smile can keep the attention off your jelly rolls.posted by Civil_Disobedient at 2:24 PM on October 3, 2007 [1 favorite]

Haven't you been listening? The morbidly LOLbese don't age, they DIE! It's like Logan's Run over here.posted by SassHat at 3:54 PM on October 3, 2007 [2 favorites]

Aw, SassHat, you misunderstand me -- I just want to smugly check out what all those underweight and normal weight 18-20 year olds look like after 30 hits.posted by desuetude at 4:09 PM on October 3, 2007

Oh, related but serious -- Orb, I'm sure you're in no danger of your insurance caring that you're underweight unless you've been treated for an eating disorder. Or you do indeed blow away and sustain expensive injuries.posted by desuetude at 4:13 PM on October 3, 2007

The difference between men and women is that women are supposed to have 'stay slim and hot' as job one, no matter what their genetic legacy, no matter what their age, and no matter what their other responsibilities.

I can get down to 125 pounds at 5'5", and have, many times -- even now, in my 40's -- as long as I put my whole heart and soul into it. But I can't eat three meals a day -- or even a whole sandwich at lunchtime -- and maintain that. So the hell with it: I'm not a size 4 or 6, I'm a 12.

At some point, actually *doing* something: publishing the book, running the company, raising the kid, developing the software, working up the classes, managing the lab or running the ward become way more important than fitting into the size 4 pants. And it's way easier to do those other things when you don't have to find or pack the special 150 calorie lunch -- or do them on the 150 calorie lunch.posted by jrochest at 4:29 PM on October 3, 2007 [4 favorites]

No eating disorder, just naturally tiny. Though everyone always accuses me of starving myself ... until they see I eat normally and don't visit the bathroom right after.

And desuetude, if you want to eyeball a 42 year old who has been a BMI of 16-17 since turning 18, there are photos on my profile page. Personally, I have always wanted to be voluptuous, but I guess you gotta live with the genes you're handed.posted by Orb at 4:48 PM on October 3, 2007

I'm 5'8". At my lowest, I had a BMI of 14.6 (96lbs - underweight). At my heaviest, I had a BMI of 25.8 (170lbs - obese). At the moment, I've a BMI of 21.7 (143lbs - normal).

General consensus is that I look the healthiest and most attractive I ever have at my current weight. But I won't lie, I wish I were in the 100 - 120 range during swimsuit season.posted by sephira at 4:49 PM on October 3, 2007

I'm Julia, in the Wonder Woman outfit who is linked as Morbidly Obese. (and for the person who complained they can't see my body clearly, or that I'm abusing the fat girl angle, you can go here to see more of the costume (it was made for me by a friend).

One of the reasons I submitted a photo to the project, is that I don't think people have a good idea of what people look like at different weights. Also, when headlines blare about the obesity crisis, and all the "morbidly obese" people, they're not referring to people who are my size, as well as people who are significantly larger than that.

At my BMI, I'm a candidate for weight loss surgery and apparently about to drop dead of disease. At 33 I should be feeling the negative affects of this deadly fat I have. And yet my blood pressure is fine. My cholesterol levels are great. I don't have diabetes or any signs of developing it (and that is with a family history of having the disease). My doctor thinks I'm healthy at this weight. I don't eat three desserts a day, or have a frequent eater card at McDonalds.

I'm not saying I'm not fat. I am fat. It describes what my body looks like. I'm also a brunette. I'm short. I have curly hair. None of adjectives should be considered insulting. They also don't have anything to do with my health.posted by thatjulia at 4:59 PM on October 3, 2007 [6 favorites]

Except "fat" does. Sorry, but it does. It might not affect your blood pressure at this level. It might not affect your cholesterol. But your cardiovascular system is under more strain than it would be if you were less heavy. Right now that may not matter; it will likely matter quite a bit in 25 years.

Now, you may be healthier at your weight than a skinnier person with bad blood pressure or bad cholesterol. You may be in good health overall. But it is inarguable that you would be even healthier if you were somewhat lighter. That's just a fact.

That's not a moral judgment. It's not an insult. But it is true, and being "fat" does have to do with your health in a way that being brunette, short, or curly haired doesn't.posted by Justinian at 5:13 PM on October 3, 2007 [1 favorite]

It's not an insult.

It is constantly used as one. That's the problem.

Welcome, Julia. I hope you hang around, because as smart as we mefites are, good sense on this topic (toot, toot) is still appreciated.posted by Ambrosia Voyeur at 5:16 PM on October 3, 2007

It's not an insult.

It is constantly used as one. That's the problem.

Well, two problems. People using health as an excuse to show scorn for something they find personally distasteful, and people attempting to redefine health as whatever makes them feel better about themselves.

the overweight chicks are hot.posted by jonmc at 6:09 PM on October 3, 2007

It is constantly used as one. That's the problem.

We can't be responsibly for what jerks do, though. And just because some jerks use "fat" as an insult doesn't mean that being fat is healthy.

dreamsign has it right: insulting fat people is bad. Pretending that being fat is no different than not being fat, healthwise, is also bad. A different sort of bad, obviously.posted by Justinian at 6:18 PM on October 3, 2007 [1 favorite]

bleh, I need to proofread better.posted by Justinian at 6:23 PM on October 3, 2007

dreamsign has it right: insulting fat people is bad. Pretending that being fat is no different than not being fat, healthwise, is also bad. A different sort of bad, obviously.

Thinking that other people's bodies are really any of our business (unless we're invited) is a yet another kind of bad.posted by jonmc at 6:25 PM on October 3, 2007 [5 favorites]

I am 6'4" tall. With a head is 25 inches around at the brow and a 54" chest. I'm carrying some extra weight, but based on the tables my flensed skeleton would be obese.posted by Kid Charlemagne at 6:40 PM on October 3, 2007

and for the person who complained they can't see my body clearly

I complained about the wonder woman outfit, and a lot of other people wrote to say that it was fucking rad. I happen to agree, it is fucking rad, and you do look hot in it; but, the point of the project wasn't, I don't think, to remind us that fat people can be hot (that's a fairly settled proposition on MeFi) it was to show us what people look like at different BMIs. The wonder woman suit does a crappy crappy job of that because what it shows us is a wonder woman costume, not really anything else. Saying so is no comment on how the picture looks.

It's a measure of the rhetorical poverty of the photo set that the two things could be confused.posted by OmieWise at 6:41 PM on October 3, 2007 [1 favorite]

Aw desuetude, fear not, my snark gun was aimed at the sky, not you.posted by SassHat at 7:04 PM on October 3, 2007

Thinking that other people's bodies are really any of our business (unless we're invited) is a yet another kind of bad.

We seem pretty concerned about the effects of ads, tv, etc, on people. Propagandizing fat either way isn't a healthy thing to do, either by insisting that everyone live up to some impossible svelte ideal, or by redefining healthy as whatever we see in the mirror. Positive self image is nice and not always easily come by, but you don't do yourself any favours by divorcing yourself from reality entirely and believing that healthy is whatever you feel like. Or, in the case of this thread, whatever turns you on.posted by dreamsign at 7:41 PM on October 3, 2007 [1 favorite]

Mach3avelli- you have a valid beef with the whole BMI thing: looking at your pic you can honestly say you have a "muscular build". I'm 5 lb. lighter than you, but I truly am "overweight". Right now I'm halfway between these two extremes. My problem, though, is I'm not athletic and never have been. So I can't claim the "muscular build" exception. I'm just overweight.

The reason the BMI system has some measure of validity is that my build is more typical than yours.posted by Doohickie at 8:30 PM on October 3, 2007

Positive self image is nice and not always easily come by, but you don't do yourself any favours by divorcing yourself from reality entirely and believing that healthy is whatever you feel like.

I don't think a doctor telling you to get down to a weight that would require removing a limb just because the chart they're looking at says you're overweight is right either. Plugging numbers into an online calculator is one thing; having a living, breathing human in front of you is another. Look up from the chart once in a while! I've had personal trainers do more thorough assessments of my body composition than any doctor ever has! What's wrong with that picture?

Having a (none too thin herself) gynecologist tell me, in my early to mid 20s, that I should weigh what I weighed at age 12 -- before I'd even hit my full adult height -- was not only horribly unrealistic, but dangerous. What if I had anorexic or bulimic tendencies? Doctors speak from a position of authority, and those who don't have a good self image could be swayed by their suggestions. Societal pressure is bad enough without your doctor getting in on the act.

I don't think I'm "divorced from reality" when I accept the way my body is structured. For example, there's a quickie "how big is your frame" test -- can you put your fingers around your wrist and touch at least one of them to your thumb? If you can't (I can't!), you've got a large frame. Even if I weighed 130 lbs, I still wouldn't be able to reach around my damn wrist, because bone is bone!

Coming from a long line of Vikingish, tall Swedes and muscular Germans, I am never going to be a size 8, let alone a 0. And that's ok. I just wish my health care providers were more willing to look at me realistically instead of lazily relying on averages to do their job for them.posted by bitter-girl.com at 8:33 PM on October 3, 2007

Well, it's not a perfect test. But I've done it in large groups of women and the results usually seem to shake out more or less accurately...

Also, I've seen those particular bones on x-ray, and man... no worries about osteoporosis here, I've got freaking baseball bats for bones!posted by bitter-girl.com at 8:47 PM on October 3, 2007

At 33 I should be feeling the negative affects of this deadly fat I have. And yet my blood pressure is fine. My cholesterol levels are great. I don't have diabetes or any signs of developing it (and that is with a family history of having the disease). My doctor thinks I'm healthy at this weight

In my experience (fifteen years as a physician) - every one feels pretty good through their thirties, especially if they don't have kids.

Your doctor may think you are healthy, or like so many, they are uncomfortable telling you to lose weight because it has been shown that a - patient's hate to be told that and b - patients inevitably ask how, doctors say eat less and exercise more, the patient says 'I already do', repeat ad infinitum, etc.

Welcome to the bankrupting of the American health care system.posted by docpops at 8:56 PM on October 3, 2007 [1 favorite]

I looked at those photographs and thought "Yeah, that looks about right."

I look in the mirror and think that I'm a touch overweight. 5'4", 153lb, and a BMI of 26.2.

My doctor thinks that my ideal weight is around 125lb. Given my past medical history, I'm inclined to agree. At that weight, at my height, I wouldn't look 'skinny'. Slender, perhaps. Small, certainly. But skinny? Not likely. Unhealthy? Well, the last time I was at 130ishlb, I was told I looked the healthiest I ever had. Whilst it was possible to tell when I was naked that I had a ribcage, my ribs were not standing out and were still rather padded. My thighs still touched in the middle. I was still a DD cup. I had some really good curves.

BMI is not the be-all and end-all, of course. It's a rough guide. For me, my body acts overweight until my BMI hits around 23. So, for me (and me only), 'overweight' starts a lot lower than for most. So long as I keep in mind where my personal lines are drawn, BMI is a good measure of my progress.posted by ysabet at 9:13 PM on October 3, 2007

Docpops, how do you explain the sort of nonsense I was subjected to when I was at my thinnest? (Playing competitive sports, healthy as the proverbial horse, but not within the usual BMI range for someone of my height...)

I understand some doctors might not want to tell patients to lose weight in general because of the reasons you've stated, but what's the point of asking them to get to a weight that's not only wholly unrealistic but that might also cause them to create larger health problems trying to meet that goal?

How, if at all, are doctors taught to address the problem other than reliance on BMI charts? Are there any primary care physicians out there actually doing analysis of their patients' body compositions instead of just weighing/calculating BMI? I'm genuinely curious, especially since, as I previously stated, the doctor telling me to drop to a pre-pubescent weight wasn't exactly Kate Moss either.

If Julia's doctor, relying on measurable evidence such as blood pressure, blood tests, etc thinks she's healthy -- or let's be more specific: that she falls within normal ranges on these tests -- then why should we consider her unhealthy? There are plenty of "fat skinny" people (who look skinny but are in terrible condition) out there and no one's jumping down their throats, because they happen to look more socially acceptable.posted by bitter-girl.com at 9:20 PM on October 3, 2007

Oh, Orb, I didn't mean to imply that your BMI means that you have an eating disorder. Far, far from it. I just meant that the only way that I think health insurance would even think to care about the BMI of an underweight person would be if they were going to be jerks about coverage for people with a history of eating disorders.

I'm small-boned and was naturally on the underweight side of the line until I was in my early twenties, when I finally edged up to "normal." I put on a couple more pounds than I'd like in the belly after 31, and god forbid! I express my desire to be in a bit better shape for my body (which I understand quite well, thank you) and lose a solid five pounds or so. I get that furrowed brow of "concern" and accused of wanting to be underweight. (Not by my friends, mind you. It's the acquaintances who are the worst. They "know me well enough" to insert their tiresome little snipes into conversation. People are shitty when they're projecting.)posted by desuetude at 9:23 PM on October 3, 2007

Oh, and incidentally, on that hands-around-wrist thing?

Yeah, it's what you might call inaccurate with some weight distribution patterns. When I was morbidly obese (205lb), I couldn't touch my fingers together around my wrist. Now that I'm only overweight, my fingers overlap slightly. At my lowest post-puberty weight (~130lb) my fingers overlapped a bit more. I conclude that that test is less useful to me than BMI.posted by ysabet at 9:34 PM on October 3, 2007

Damn, ysabet, I must have short fingers, then. I couldn't do it even in high school when I was running around in crazy short tennis skirts with photos of Andre Agassi pasted to the inside of my racket cover.

Those are good questions bitter-girl. I can only speak for what I know and practice, but I never see someone as 'healthy' just because they haven't developed a disease. It's like telling a smoker their chest x-ray is normal. You know the shit's gonna hit the fan, just not when. If you have a parent with diabetes (Type 2) and are overweight you will almost certainly get it. A 33 year-old woman who did have high blood pressure or diabetes would really scare me. One who didn't but who was extremely overweight would/should never hear the word healthy from their doctor. They can be commended for their efforts, encouraged, etc., but to tell them they are healthy is a good way to get sued and it's downright unfair to the patient. You are essentially misleading them.

That said, I have no idea why your doctors told you what you say they did.posted by docpops at 9:39 PM on October 3, 2007 [1 favorite]

In my experience (fifteen years as a physician) - every one feels pretty good through their thirties, especially if they don't have kids.

What?! Well, I guess it depends on what you mean by "pretty good." I get how this is true with the way our health-care system is structured -- there's no treatment if there's no disease. And thirties is well before heart disease and cancer and arthritis and a lot of other diseases associated with aging kick in. But thirties is when most people generally start feeling their age in a day-to-day way. Your weight creeps up and it's a heck of a lot harder to control it, the joints start to complain, your digestion changes, a poor night's sleep makes you feel lousy for longer.

"This doesn't feel right for my body" doesn't matter until all those vague signs turn into a disease. Sometimes they don't. Sometimes they do and in hindsight, a closer doctor-patient relationship than what is currently the norm (even for those with good insurance) could made a huge difference in people's health.

/Not a doctor, just a person with a lot of interest in medicine and health for a lot of reasons.posted by desuetude at 9:45 PM on October 3, 2007 [1 favorite]

bitter-girl, my wrist size has changed significantly between my lowest and highest weights - to the tune of about an inch or so around the bony bit. I don't think that's typical. My ring size has also changed by about 3 sizes in that range. And my glove size. And my shoe size.

Suprises the heck out of any health professionals I've talked to. That sort of stuff isn't supposed to change like that, so I'm told. The combination of a slightly unusual weight distribution and a teeny-weeny frame makes it happen, though.posted by ysabet at 9:51 PM on October 3, 2007

BMI: A mathematical justification for people being assholes.

Look. There is no "fat/not fat" dichotomy. You can be healthy or unhealthy to varying degrees, and you can be or not be okay with the way you look. A system saying "Oh, you're normal, and you're too thin, and you're too fat" is just full of possibilities for exploitation by jerks. Plus, are we forgetting that study up there saying that by and large, the people falling in the "overweight" category (especially threshhold cases) are less likely to suffer premature death?posted by tehloki at 9:57 PM on October 3, 2007

Thanks, docpops. That's one that's puzzled me for a while. And from the patient's perspective, it's awfully irritating to be told you need to weigh what you did in middle school as a grown woman.

Do you think it would be more effective to ask patients what weight *they* really felt comfortable with, when that was, and what -- if not currently that weight -- they're doing to get back there? It's less loaded as a question than the statement "You need to weigh [#]." Not to mention you can correct unrealistic expectations along the way. So, let's take me for an example:

Dr. X: What weight are you most comfortable with?
Me: 163
Dr. X: When was that?
Me: High school

And if they give you a crazy number -- for me, 135 would be pretty insane, given my frame, height and history -- you can say "ok, but that was high school, and that was [x] years ago... the range for your height is 150-170. Would you be ok with 170?"

Then, work to get towards that goal first instead of setting some arbitrary number with no relationship to that person's size now or ever. I suspect the resistance -- and I'm guilty of it, too! -- to fiat from above comes from what we perceive as unrealistic expectations more so than not knowing what to do. It's paralyzing to be told to do something you just know isn't going to happen, and it keeps you from making the smaller, more reasonable first step in that direction.posted by bitter-girl.com at 9:59 PM on October 3, 2007

Wow, ysabet, that is funky. Out of curiosity, if you don't mind answering, did your shoe size go back down when your weight did? I'm blaming constant Birkenstock-wear for my foot spread, but who knows? And my acupuncturist (who's 6' tall, thin, and runs every day) has also gone up 2 shoe sizes since I met her. We were starting to wonder what was wrong with us!posted by bitter-girl.com at 10:03 PM on October 3, 2007

What?! Well, I guess it depends on what you mean by "pretty good." I get how this is true with the way our health-care system is structured -- there's no treatment if there's no disease.

What I mean is that the visits for aches, pains, fatigue, and the clinical signs of disease, in most cases, don't start until you get into your forties. YMMV. It's not a contest.

I had a resident supervisor in med school who used to lecture us on the proper stages of life - sex, food, and bowel. The point being that people in good physical and emotional health tended to focus on different things at different points in life. And it was OK to still be in your sex phase or food stage late into life, but seeing someone skip one for another, especially to go straight into the bowel phase prior to sixty, was generally a bad sign.

So far he's been right every time.posted by docpops at 10:05 PM on October 3, 2007

Do you think it would be more effective to ask patients what weight *they* really felt comfortable with, when that was, and what -- if not currently that weight -- they're doing to get back there?

Absolutely, and it's exactly what I often do.posted by docpops at 10:05 PM on October 3, 2007

bitter-girl, my foot size certainly has gone back down. In australian sizes, I was an 8 at my highest, down to a 6.5-7 at my lowest weight. Tested on unworn, new shoes in the same style over the course of a couple of years. Rebuying my fav shoes sorta sucked.posted by ysabet at 10:22 PM on October 3, 2007

I had a resident supervisor in med school who used to lecture us on the proper stages of life - sex, food, and bowel. The point being that people in good physical and emotional health tended to focus on different things at different points in life. And it was OK to still be in your sex phase or food stage late into life, but seeing someone skip one for another, especially to go straight into the bowel phase prior to sixty, was generally a bad sign.

Your supervisor rocks. That is perfect and matches my experience exactly.posted by Justinian at 11:54 PM on October 3, 2007 [1 favorite]

Now, you may be healthier at your weight than a skinnier person with bad blood pressure or bad cholesterol. You may be in good health overall. But it is inarguable that you would be even healthier if you were somewhat lighter. That's just a fact.

I don't like BMI, but I'll concede this point. It's probably true. However, what isn't true is that every person can lose weight without introducing other health problems, even if that person is above 'healthy' weight. The notion that weight changes can be arbitrarily executed without other effects given enough will power is false and malicious. It's not a rationalization for many people who are above optimum weight to argue that they are at their personal healthiest weight. It's the truth. Dieting takes a health toll, and for many people, it's not possible to lose the weight and keep it off without perpetually dieting.

Fat affects health. This is true. But the amount of fat needs to also take into account how people get to those weights.

Me, I'm on the other end of the scale. 5'10", 125lbs, which puts me just into underweight. This hasn't changed more than +/- 5lbs since I stopped growing. I have a thin frame, little fat, and, I suspect, weird muscles. I've always been very flexible for my age/sex, and they get stronger without really adding mass very much. So, I'm underweight, but I seriously doubt it's anything unhealthy for me. Similarly, many people outside of optimum on the high end are healthy, and that's just the truth.

Which is to say, the optimum weight for an individual should more accurately be the closest they can comfortably and healthily get to what is statistically optimum. Individuals are not statistics, and the constant reminder that a given person is outside of statistical optimum is both tiresome and unhelpful.

Which goes to the fact of why this is so contentious in the first place: we are, as a society, squicked out by fat. The problem is that, even more strongly, we're disgusted by it, with all the moral overtones that carries. This carries over into this debate, although few are willing to admit it. Fat is a perfectly accurate term, but people don't use it to mean someone heavy. They use it to mean "someone I find unpleasant/distasteful/disgusting because of how they are heavy". Nearly all discourse about weight revolves around this, no matter how much people try to dress it up with the actually real and valid health concerns.

This part is tricky for me because I'm not above it. I'm somewhat squicked by fatness. I can admit this, and I can be so comfortably because I am skinny by nature. I refuse, however, to be disgusted by it, and I also deplore the institutional and damaging nature of how this squick is propagated. The media is horrible, other people's bodies are just that, and people need to get over themselves.

I am 6'4" tall. With a head is 25 inches around at the brow and a 54" chest. I'm carrying some extra weight, but based on the tables my flensed skeleton would be obese.

You've indirectly hit upon the other problem with BMI that few seem to talk about: It works poorly at extremes of height. Which makes sense as people get bigger cubically, not squaredly. Maybe the best relationship is somewhere in between, I dunno, but 6'6"/250 probably shouldn't be obese.posted by Kwantsar at 7:26 AM on October 4, 2007 [1 favorite]

BTW, can I just give a major shout-out for use of the word "flensed"? I love that word. Not often do you get the chance to use it these days.posted by bitter-girl.com at 8:36 AM on October 4, 2007 [1 favorite]

roofuswrites"Am I wrong for thinking that the 'overweight' people do indeed look overweight, and that the 'obese' people are uniformly obese? Not one of these photos surprised me in the slightest, although obviously it's hard to guess who is normal and who is overweight between a BMI of about 23-27."

I don't know if you're wrong, but you're certainly not alone.
The "underweight" link went to a picture of someone who looked underweight.
The "normal" link went to a picture of someone who looked normal.
The "overweight" link went to a picture of someone who looked overweight.
The "obese" link went to a picture of someone who looked obese.
The "morbidly obese" link went to a picture of someone who looked morbidly obese (admittedly, the bottom end of morbidly obese, because there is no upper end).

BMI may be a crock of shit, but posting pictures of people whose BMI classifications look like they fit perfectly is not exactly the best way to make that argument.posted by Bugbread at 9:10 AM on October 4, 2007

I think that many people would be surprised by what 180lbs looks like.

To add to what bugbread said, a rough mental calculation tells me that 180lbs = approx 80 kg. I'd guess that a woman less than about 6'2" who weighed 80kg would be pretty chubby. And guess what? The woman in the photo is pretty chubby.

(not saying that there's anything wrong with that - it's not to my taste, but YMMV - but she looks exactly as i would have expected. that's based on guys i know who are >6' & lift weights for more than 6hrs per week - ie quite built-up - & who weigh around 80kg. for a woman to weigh as much as that, i'd have to assume she's pretty well padded unless she's a giant)posted by UbuRoivas at 10:43 PM on October 4, 2007

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